Respiratory

Question 1

salmeterol

Answer 1

Class: long acting Beta 2 agonist
Indications: long term COPD/Asthma management with an inhaled corticosteroid
P’dynamics: Beta 2 effects
P’kinetics: hepatic CYP3A4; T.5 =5.5h;
Tox: dizziness, sinus infection, migraine
Pregnancy C

Question 2

formoterol

Answer 2

Class: long acting Beta 2 agonist
Indications: long term COPD/Asthma management with an inhaled corticosteroid
P’dynamics: Beta 2 effects
P’kinetics: hepatic CYP3A4; T.5 =5.5h;
Tox: dizziness, sinus infection, migraine
Pregnancy C

Question 3

cromolyn

Answer 3

Class: leukotriene receptor agonist
Indications: inhaled 
P'dynamics: stabilizes mast cells; prevents degranulation
P'kinetics: T.5=1.3h
Pregnancy B

Question 4

fluticasone

Answer 4

Class: glucocorticoid
Indications: asthma, allergic rhinitis
P’dynamics: selective glucocorticoid receptor agonist; anti-inflammatory, vasoconstrictive
P’kinetics: hepatic CYP3A4; T.5=10h
Tox: minimal with proper use
Interactions: ketoconazole, CYP3A4 inhibitors

Question 5

hydrocortisone

Answer 5

Class:
Indications
P'dynamics
P'kinetics
Tox
Interactions
Pregnancy C

Question 6

prednisone

Answer 6

Class: corticosteroid
Indications: asthma, COPD, allergic
P’dynamics: prodrug to active prednisolone
P’kinetics: Hepatic
Tox: hyperglycemia, fluid retention, depression, anxiety
Pregnancy C

Question 7

methylprednisolone

Answer 7

Class: glucocorticoid
Indications: anti-inflammatory, bronchial inflammation
P’dynamics:
P’kinetics: hepatic CYP3A4
Tox: hyperglycemia, fluid retention, hypertension, immune compromise
Pregnancy C

Question 8

montelukast

Answer 8

Class: leukotriene receptor antagonist
Indications: asthma; seasonal allergies
P’dynamics:CysLT1 antagonist, blocking LTD4, LTC4, LTE4; reduces bronchoconstriction + inflammation
P’kinetics: hepatic CYP3A4, CYP2C9
Tox: GI, headache, hypersensitivity rxns, sleep disorder, Churg-Strauss
Pregnancy B

Question 9

fexofenadine

Answer 9

Class: 3rd generation antihistamine
Indications: seasonal allergies, congestion, urticaria
P’dynamics: peripheral H1 blocker; doesn’t cross BBB; non drowsy
P’kinetics: Hepatic
Tox: well tolerated
Interactions: erythromycin, ketoconazole; no QT prolongation.
Pregnancy C

Question 10

omalizumab

Answer 10

Class: monoclonal Ab
Indications: allergies, allergic asthma
P'dynamics: inhibits IgE binding to FceR1
P'kinetics: T.5 = 26 DAYS!
Tox: allergic reaction
Pregnancy B

Question 11

diphenhydramine

Answer 11

Class: 1st generation antihistamine; ethanolamine antihistamine
Indications: allergies, parkinsonism, extrapyramidal symptoms, sleep aid
P’dynamics: peripheral H1 inverse agonist = allergy releif; central H1 antagonist = sedation; mAChR agonist = anticholinergic; Na channel blocker = local anesthetic
P’kinetics
Tox: potent anticholinergic; drymouth, tachycardia, mydriasis, urinary retention, hallucination; adaxia, cycloplegia, photophobia, sedation,
Interactions:
Pregnancy B

Question 12

dextromethorphan

Answer 12

Class: antitussive; sedative, disassociative
Indications: cough suppressant,
P’dynamics: nAChR antagonist
P’kinetics: hepatic CYP2D6, CYP3A4, CYP3A5; T.5 - 2-4h; renal excretion; F=~11%
Tox: N/V/D, drowsiness, dizziness
Interactions: MAOI/SSRIs= seretonin syndrome
considerations: anaphylaxis in atopic children?

Question 13

codeine

Answer 13

Class: opiate
Indications: pain, antitussive
P’kinetics: Hepatic CYP2D6; active metabolite=morphine
Tox: constipation, drowsiness
Interactions: paroxetine, fluoxetine, diphenhydramine, bupropion
Pregnancy C